Issues

Women living with HIV/AIDS often place the needs of their families ahead of their own, including health care. Ryan White outreach and primary care programs empower these women to live longer, healthier lives and HRSA works to better educate providers to address the unique needs of this population.

Gay men have been heavily impacted by HIV/AIDS since the beginning of the epidemic. Gay men have helped lead the way towards creating high standards of culturally competent care and integral to the creation and direction of the Ryan White HIV/AIDS Program.

Culturally competent service providers are crucial to recruiting and retaining people living with HIV/AIDS into primary care, particularly when they are members of historically disenfranchised communities and populations such as people of color, gay men, women, and substance users.

The Ryan White HIV/AIDS Program ensures people living with HIV/AIDS have access to the latest treatments, including life-saving AIDS medications. Advances in vaccine and pharmaceutical research promise new ways to treat, and perhaps halt, HIV infection in the future.

African-Americans are the racial and ethnic group most disproportionately affected by the HIV/AIDS epidemic. By providing culturally competent, comprehensive care the Ryan White HIV/AIDS Program is committed to turning this tide.

Wonderful advances in treatment have brought with them the promise of longer life for people living with HIV. The Ryan White HIV/AIDS Program has been there, growing with the people it serves and ensuring that the program’s aging patients have many years of good health and happiness to look forward to, every step of the way.

Stigma represents one of the most complex and pervasive barriers to health care for people living with HIV/AIDS. From the beginning, the Ryan White HIV/AIDS Program has fought against the discrimination and isolation that stigma creates, a commitment that helps more people engage and remain in care.

In rural America, unique challenges add to the complexity of providing care for people living with HIV/AIDS. The Ryan White HIV/AIDS Program is, thus, a critical source of support in remote areas, helping patients overcome barriers to care as well as providing technical assistance for providers.

Youth represent the only age group in the United States still experiencing increases in HIV diagnoses. The Ryan White HIV/AIDS Program is working tirelessly to find ways of reaching more of these at-risk young people and providing the kind of comprehensive, responsive care that can change lives.

HIV/AIDS Stigma and the History of the Ryan White HIV/AIDS Program

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Shana Cozad from Tulsa, OK, was a 22-year-old college sophomore with a 2-year-old son. She had decided that she wanted to end her relationship with her boyfriend, but when she finally told him, she got a response that came out of nowhere. “He said I couldn’t break up with him because he had AIDS. He said that he had chosen me as the person he wanted to die with.”

Cozad was taken totally off guard by her boyfriend’s admission, yet strangely, in retrospect, she was not overly alarmed. After all, “How could he have AIDS?” she asked herself. “He doesn’t look sick.” Besides, she thought, AIDS happened to “other people who had multiple partners and were not responsible like me. I had asked him the ‘right’ questions.”

Encouraged by a friend, Cozad went to her college clinic to be tested for HIV. A week later, the school nurse cried when she told Cozad that she was HIV-positive. There were soon additional tests, and they showed that her infection had progressed to AIDS. Frightened, Shana reached out to her family. “They were embarrassed and didn’t want to talk to me,” she recalls. “My mother essentially said, ‘Good luck, you’re on your own.’”

The year was 1992, and by that time legions of people infected and affected by HIV/AIDS had experienced the kind of rejection that Cozad received from her family. There had already been 11 years’ worth of discrimination, cruelty, abandonment, and unnecessary suffering for people living with HIV/AIDS (PLWHA), caused by the enormously complex phenomenon known as stigma. For more than a decade, people had lost jobs and health insurance coverage, been kicked out of apartments, and been shunned by family and friends. The stigma of HIV/AIDS caused people to be denied care by doctors, nurses, and the very institutions whose first charge is to do no harm. The result? PLWHA were often isolated. They endured untold emotional and physical suffering. Stigma—both external and internalized—led to many people dying in misery and solitude.

Cozad’s story would turn out differently. When she was diagnosed with HIV/AIDS, the Health Resources Services Administration (HRSA), HIV/AIDS Bureau’s (HAB’s) Ryan White HIV/AIDS Program was almost 2 years old. It had been designed to help and support people just like her. Cozad found a caring group of providers and fellow patients at the local Ryan White-funded HIV clinic. Instead of rejection and abandonment, Cozad encountered the compassionate, affirming, and supportive approach to care that is a hallmark of the Ryan White HIV/AIDS Program. The stigma-defying environment she encountered motivated her to stay in care. Ultimately, it also saved her life.

8. United States Conference of Mayors. Hunger and homelessness survey. A status report on hunger and homelessness in America's cities—A 23-city survey, December 2007. December 2007. Available at: usmayors.org/hungersurvey/2006/report06.pdf (PDF – 732 KB).